Starting in ICU

Tacomaboy3 · Jul 17, 2017

I was a new grad in the ICU.
How did it go?
Not so good at first.
Orientation and the initial year after orientation was pretty terrible. For both me and my patients, honestly. I should not have started in my ICU--I had zero health care experience, not even as a CNA. I was also horribly nervous and timid and unsure of myself. Looking back over my first few months after orientation, I can't believe that I didn't kill anyone. I cried every day. I threw up from stress many times.
It was not a good experience. If I had it to do over again, I would have started on a med-surg floor and worked my way up.
That was my experience (pretty timid person, scary-sick ICU patients, no healthcare experience, but Unit is super-short-staffed, so you got hired!), your experience might be different.
Having said all that, I did make it. I'm still there, eight years later. We've had a new Manager for the last five years, and she is wonderful. I am a resource and expert to many other staff members. I am the go-to preceptor. It's pretty great, and while I might grumble sometimes about having to wake up early to go to work, I love my job. I am exceptionally good at my job, and that feels amazing, every day.
Do you wish you had prior experience in another unit before the ICU?
I absolutely, 100% wish I had. I would have been so much better prepared with a year or two of med-surg under my belt. I am not exaggerating about how bad that first year after orientation was.
Having said that, I have precepted quite a few new grads. Nearly all of them have been equipped, inquisitive, delightful, knowledgeable, valuable members of our staff. I have been so impressed by their drive to learn and how well and quickly they have adapted to our Unit.
I don't know what they have that I didn't, but they are way better than I was.
Did you feel well-supported as a new grad in the ICU?
Not at all.
Our unit now has a program for new hires for the first year. They meet every few weeks to work on projects?

I appreciate your response. I work in an ICU (and its step-down) as a CNA while currently in school. I have a great relationship with my managers and am confident they would extend a job offer for the ICU residency upon my graduation and passing the NCLEX - many new grads right now are entering the ICU residency, then working in the step-down for 6-12 months before transitioning to the ICU. I think want to follow the same path.

LovingLife123 · Jul 21, 2017

I started in icu. I'm still there 3 years later. I have to disagree with PP that say you need to start in medsurg and icu new grads have no respect for any other type of nursing. That is simply not true.

I had a good orientation and supportive unit. MedSurg was just not for me and I knew that going into the field. My unit is not for everybody on the flip side. Some people just cannot handle it. That doesn't make them any less of a nurse, sometimes personalities don't mesh with the pace of the job. My particular ICU is very intense and face paced.

I love my job. Certain days are very trying, but I love it. I wouldn't want to be anywhere else.

KeepinitrealCCRN · Aug 24, 2017

so many things to say about this. i had 1.5 years of tele experience before moving to SICU and i am very very thankful for that. i got to learn cardiac meds and rhythms as well as time management and just how the whole hospital runs among many other things. being new to nursing and to working in a hospital can be overwhelming in general.

i believe if you are a new grad going into ICU and you are part of a longer orientation (6 months) then it is ok but new grads who are only given 3 months and then thrown out there tend to not do well. even med/surg nurses come to the ICU and struggle because the learning curve is steep.

in my opinion it is best to work telemetry or on a step down unit then transition to ICU or get into a residency or orientation that is longer than 3 months and you will excel. you can teach almost anyone with a nursing license how to be a nurse but you have to have the drive and interest to be your best, but that applies to most things in life.

purplegal · Aug 29, 2017

Wish I could get a position in ICU at all, let alone as a new grad

outriton · Sep 8, 2017

I was a new grad who started in the same SICU that I did my preceptorship/leadership hours in during my last semester of nursing school. I think that made a big difference for me because I was already familiar with the staff, equipment, charting, etc. so the learning curve was slightly less steep. There wasn't a formal new grad residency program when I was hired, but I was buddied up with a more experienced nurse for a 3-month unit orientation. At the MICU I'm at now, there is a new grad residency program and the new grads that are hired are buddied up for a 6-month unit orientation. I think ICUs that hire new grads are cognizant of their needing more support and generally will provide it.

I think you just really need to be self-aware about whether you think your critical thinking is where it needs to be to safely care for ICU patients. Nursing is a career change for me so I was older, had a strong science background, and was very disciplined and driven since this is what I realized I wanted to do instead of my previous job, and I think those factors really helped me be able to start out in the ICU. I don't think I necessarily could have done it as my immature 22-year-old self.

ShanHK · Sep 28, 2017

I'm about 2 months into my residency program as a new grad in the ICU and it's definitely overwhelming!

My school did not make it mandatory for a critical care class nor did I have a clinical rotation in critical care.

I did however get lucky and land my senior practicum in the ICU but that was only 7 shifts in one month.

With that said, I love the ICU. I love the fast-paced, always on your toes, nurse autonomy- aspect of it.

HOWEVER, I am wishing I had more background/experience prior to coming here.

I feel like nursing school did not prepare me for critical care nursing and I am harsh on myself for not knowing things that I feel like I should know as a nurse in the ICU (it's quite normal not to know anything, but still... as a partial-perfectionist, it is very bothersome).

A lot of the nurses that I work with started off in the ICU as a new grad and they are certainly thriving here.

But I have also heard of some in the residency program dropping out because they couldn't handle it for whatever reason.

It's definitely a different cup of tea and it's not for anyone.

I'm still getting used to a lot of things and still questioning whether I made the right choice.

Whatever the case may be, whenever or if you ever decide to go to the ICU, you will learn A LOTTTTT and a lot will be required from/of you.

It's a great learning environment. GOOD LUCK !

EternalFeather · Oct 27, 2017

I started in ICU as a new grad. it was definitely stressful and difficult. However, it was WORTH IT, to me personally. I had a preceptor with a very "strong personality" it was an expert nurse who was very good at what she does but she was that somewhat cruise control type and she expected me to know what she knows, which is not even possible considering her years of experience. she was that popular and respected "amazing nurse" (both in good and bad way). Before me, she had a preceptee who surrendered and basically asked the director to be transferred and I didnt know until a staff have told me.

I found myself getting eaten alive by her! I did not know a lot and I asked so many questions and get scolded and yelled at and all that jazz. she did not care if it was around patients, other staff and doctors and visitors. It was the worse because others would laugh and whatnot, it was just so humiliating.

Even so, I was still asking, not just her, but the other staff and even the administrators who make rounds in the unit, which was funny because every staff usually avoids them. I was triple-double checking every single thing and it sometimes would lead me to being late with my treatments or not being totally aware of other important details besides just the basic stuff to do with a patient. It is ICU so you have to know everything my time management sucked and I would get reprimanded for it. After a few shifts she started to leave me to my own device, only checking on me every few hours to yell and critique in a negative way. It was like working in fear of making mistakes and losing my license which i worked so hard for. she had no patience for my lack of bedside skills and questions.

I would not be lying if I say that there were times that I almost cried. It was horrible.

I don't know if anyone would have stayed through months of that like i did, but eventually, like about at the end of my orientation, she started to be less of a witch. When I became familiar with the charting software and other basic stuff... she even became as nice as to teach me things nicely instead of making me look a fool in front of others. Funny enough, she told me that I was good enough but not "there" yet... which was oddly huge coming from her. She even wanted to help me to be a charge nurse eventually - she was often the charge nurse with patients. I still feel so strange about that.

Honestly, I do not know what I learned from her. Maybe just being as half as mean as her.

of course, my skills are still developing and i am constantly evolving. I am never going to be as mean to my preceptees.

But because of what she did to me, I learned some skills, like to be more careful, be more confident, turn on my critical thinking cap better, assertive and be mean at appropriate times ; I remember having good comebacks for her insults lol.

TLDR?

My preceptor was a witch. Now, I'm an angel.

Wolf at the Door, BSN · Oct 28, 2017

You're right. This HAS been asked NUMEROUS times before.

:banghead:It's a monthly thing I swear. I don't understand original poster, what do you really want out of this question where numerous information exist? Why have a bunch of stranger/nurses on the internet tell you how to live your work life? Only those close to you and YOU know what's best for YOU. You have to decide what are you goals in 3-5 years and would ICU help meet those goals.

Tacomaboy3 · Nov 24, 2017

:banghead:It's a monthly thing I swear. I don't understand original poster, what do you really want out of this question where numerous information exist? Why have a bunch of stranger/nurses on the internet tell you how to live your work life? Only those close to you and YOU know what's best for YOU. You have to decide what are you goals in 3-5 years and would ICU help meet those goals.

I thought my questions were pretty clear - I was mostly curious about personal experiences, not necessarily asking whether I should do it or not. If you didn't understand my original questions, I'm unsure how I could reword them to be clearer.

But thanks for your post - I feel enlightened and thrilled to know I'm in charge of my life.